2 minute read

Understanding Amblyopia or “Lazy Eye”

MICHAEL COLE, OD Child and Family Eye Care Center

One of the most common conditions treated in our office is amblyopia. Most people call amblyopia “lazy eye.” This occurs when normal vision development is unable to occur in one or both eyes. When we are first born, our vision is quite underdeveloped. The eyes themselves are remarkably complete upon birth, but it isn’t until later that we learn to use them well. Our vision is very blurry, our eyes do not work together, and our brain does not know how to process visual information well for many months. If there is anything that prevents this normal developmental process from happening, the result is an underdeveloped and underused eye that does not see well.

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Amblyopia affects much more than eyesight alone. This interruption in visual development also reduces our ability to shift focal distances, make accurate eye movements, judge timing and depth, slows conduction of information to the brain, and the list goes on and on. If an eye is not able to learn these skills during the proper time, the other eye, along with the brain, will leave it behind and learn to navigate the world without it. I would say that the eye isn’t “lazy,” but rather it is being bullied by the other eye who has taken over.

The more we learn about amblyopia, the more we understand the profound effects this condition has on the function of the entire body. Recent studies published in the Journal of the American Medical Association highlight the struggles of amblyopic children in academics. These studies concluded that children with amblyopia read slower than their normal vision peers. The effects of amblyopia were even greater than children with an eye turn. Think of that — it is actually less of an obstruction for the brain to completely turn an eye off and move it out of the way than it is to try to use an untreated amblyopic eye!

Another study revealed that it takes children with amblyopia much longer to complete multiple choice tests using scantrons. With so much emphasis put on standardized testing using bubble sheets, it certainly puts these children at a disadvantage. The authors of this study state: “Longer completion time in children with amblyopia or strabismus may affect a child’s performance on tests using multiple-choice answer forms and may hinder academic success.” Despite this conclusion, it would be extremely rare for these students to receive any accommodations to help them succeed.

Untreated binocular vision disorders are also linked to overall physical coordination issues, including motor deficits. Young children show gross and fine motor delays. Older children are much less likely to excel at sports. Another research article recently observed that amblyopic children not only had reduced performance, but also held a more negative self-perception than the control group. Those affected often must cope with both the physical shortfalls as well as compounding emotional consequences.

Unfortunately, it is all too common to hear parents lament the fact that they wish they had known sooner that their child was struggling in this way. While it is reassuring to know that treatment exists and is effective, I would encourage parents to schedule eye exams early, usually around 1 year old. Please do not wait until other problems crop up before a comprehensive eye exam!

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